Ungangove wave uchitambura nekurwadziwa kwemudumbu kwenguva yakareba nekuda kwematombo emudumbu. Pawakazovhiyiwa kuti ubvise gallbladder yako, pamwe waifunga kuti wasunungurwa zvachose kubva pakurwadziwa uku. Asi ko kana uchiri nekurwadziwa kwakafanana kwemudumbu mushure mekuvhiyiwa? Zvinonetsa chaizvo. Vanhu vazhinji vanosangana nedambudziko rakadai. Saka nhasi tichataura nezvechirwere chinogona kukonzera kurwadziwa kwemudumbu uku kusinganzwisisike kunyangwe gallbladder yabviswa. Ndiyo Sphincter yeOddi Dysfunction .
Zvichitaurwa zviri nyore, chii chinonzi Sphincter of Oddi Dysfunction?
Kuti tinzwisise izvi, ngatitangei tatarisa maitiro ekugaya kwedu. Zviri nyore kwazvo. Patinodya chikafu, miviri yedu inogadzira muto miviri yakakosha inobatsira kugaya chikafu.
1. Nyoro: Izvi zvinogadzirwa nechiropa. Zvinochengetwa munduru. Zvinobatsira mukugaya mafuta.
2. Muto wepancreatic: Uyu unogadzirwa nepancreas. Ma enzymes ari mairi anobatsira kugaya mapuroteni nema carbohydrates ari muchikafu.
Majusi ese aya anoenda kudumbu redu diki, uko anosanganiswa nechikafu kuti apedzise kugaya chikafu.
Zvino hechino chinhu chakakosha. Panopinda majusi maviri aya muura hudiki, pane kanyama kadiki kakaita segedhi . Kakaita sevharuvhu. Izvi ndizvo zvatinodaidza kuti Sphincter of Oddi . Kazhinji, kana uchida kugaya chikafu, gedhi iri rinovhurika, majusi anopinda, uye rinovhara zvakare.
Dambudziko reSphincter of Oddi rinowanzoitika kana suo iri risingashande nemazvo. Kureva kuti, chidimbu ichi chenyama hachivhurike panguva yachinofanira kuvhurwa uye chinova chakaoma. Ipapo nyongo inobva muchiropa nemuto wepancreas hazvigone kupinda muura hudiki zvobva zvabatwa. Zvinoita sekunge kune vanhu vakawanda vari mumigwagwa. Kana muto wacho wabatwa seizvi, kumanikidzwa kwemumigwagwa kunobva muto iwoyo kunowedzera, zvichikonzera kurwadziwa mudumbu zvakanyanya.
Dambudziko iri rinowanzoonekwa kuvanhu vakabviswa nduru yavo nerubatsiro rwekuvhiyiwa. Saka, dzimwe nguva inonzi post-cholecystectomy syndrome .
Ndeapi marudzi makuru echirwere ichi?
Kusashanda zvakanaka kweSphincter yeOddi kunogona kukukanganisa nenzira mbiri huru.
- Biliary Dyskinesia: Ichi chirwere chinoita kuti ducts dze bile dzivharike. Dambudziko riri munzira iyo bile rinoyerera nayo.
- Pancreatitis: Apa ndipo apo muto wepancreas unovharika, zvichiita kuti pancreas izvimbe uye izvimbe.
Pamusoro pezvo, vanachiremba vanopatsanura chirwere ichi muzvikamu zvitatu (Zvikamu I, II, uye III). Izvi zvakakosha zvikuru nekuti kurapwa kunoenderana nechikamu ichi.
| Rudzi rwechirwere | Tsananguro |
|---|---|
| Chikamu I | Murwere ane kurwadziwa nemudumbu. Pamusoro pezvo, pane humbowo hwakajeka hwedambudziko iri kubva mukuongororwa kweropa uye kuskenwa (ultrasound) . (semuenzaniso, ma enzymes echiropa akakwira, ducts dze bile dzakakura). |
| Chikamu II | Murwere ane kurwadziwa nemudumbu, uye kamwe chete kekuongororwa kweropa kana kuti scan kunoratidza kusarongeka. |
| Chikamu III | Rudzi urwu ndirwo rwakaoma kuona. Murwere ane kurwadziwa nemudumbu, asi hapana kuongororwa kweropa kana scan kunogona kuwana chisina kunaka. Humbowo chete ndehwekurwadziwa kunonzwa murwere. |
Ndezvipi zviratidzo zvikuru zvechirwere ichi?
Chiratidzo chikuru uye chinowanzoonekwa kurwadziwa kwakanyanya mudumbu, kwakafanana nekurwadziwa kunoitika nematombo emunduru.
- Marwadzo anotangira kumusoro kurudyi kwedumbu.
- Dzimwe nguva kurwadziwa uku kunofambawo kuenda pafudzi rekurudyi kana kumusana .
- Marwadzo acho haagari kwenguva refu. Anopera ega mushure memaminitsi angangoita makumi matatu kana awa. Ipapo anogona kudzoka zvakare mukati mezuva rimwe kana vhiki.
- Mamwe mazuva kurwadziwa kwacho kushoma, asi mamwe mazuva kunogona kusashivirira.
Kuwedzera kune kurwadziwa kukuru uku, zviratidzo zvinotevera zvinogonawo kuitika:
- Kusvotwa nekurutsa
- Fivha uye dzihwa
- Manyoka
Chinhu chakakosha ndechekuti zviratidzo izvi hazviwanzoonekwa nguva dzose. Zvinowanzo vapo zvichienda.
Ndiani ari panjodzi huru yechirwere ichi?
Chikonzero chaicho cheizvi hachisati chawanikwa, asi zvimwe zvinhu zvinowedzera njodzi yechirwere ichi.
| Chinhu chine njodzi | Tsananguro |
|---|---|
| Kubviswa kwenyongo | Ichi ndicho chinhu chikuru uye chinonyanya kukonzera njodzi. |
| Zera uye murume kana mukadzi | Dambudziko iri rinonyanya kuitika kuvakadzi vane makore ari pakati pe20 ne50. |
| Kumwe kuvhiyiwa | Kuvhiyiwa kwekudzikisa huremu (semuenzaniso kuvhiyiwa kwemudumbu), kuisirwa chiropa, nezvimwewo. |
| Zvimwe zvirwere | Zvirwere zvakaita se recurrent pancreatitis, hypothyroidism, uye irritable bowel syndrome (IBS). |
| Mimwe mishonga | Kushandisa mishonga yekurwadziwa kwemusoro kwenguva refu (kunyanya opiates). |
Chirwere ichi chinoonekwa sei?
Kana chiremba wako achifungidzira izvi mushure mekunzwa nezvezviratidzo zvako, chinhu chekutanga chaachaita ndechekuona kuti hapana chimwe chikonzero chakakomba chekurwadziwa kwemudumbu mako. Izvi zvinodaro nekuti zvimwe zvirwere zvakaita semaronda emudumbu (peptic ulcers), matombo emunduru, uye kenza yepancreatic kana bile duct zvinogonawo kukonzera zviratidzo zvakafanana. Dzimwe nguva, kurwadziwa kwechirwere chemwoyo (angina) kunogonawo kunzwa sekurwadziwa kwemudumbu.
Mushure mekusimbisa kuti zvinhu izvi hazvipo, bvunzo dzinotevera dzinogona kuitwa kuti utarise Sphincter of Oddi Dysfunction:
- Kuongororwa kweropa:Tarisa kana paine mazinga akakwira eenzyme yechiropa nepancreas.
- Kuskena: Kuskena kwakadai se abdominal ultrasound, CT scan, uye MRCP kunoshandiswa kutarisa kana duct ye bile kana pancreatic duct yakazvimba/yakakura.
- Endoscopy: Chubhu ine kamera inopinzwa nemuromo kuti iongorore dumbu neura hudiki.
Bvunzo reERCP
Mune zvimwe zviitiko, kunyanya kana paine chinofungidzirwa kuti rudzi rwekutanga kana rwechipiri, bvunzo yakakosha inonzi ERCP (Endoscopic Retrograde Cholangiopancreatography) inoitwa. Muizvi, chubhu yekamera inoiswa, yakafanana ne endoscope, mu sphincter yaOddi, uye chubhu diki inoiswa kuti ione kumanikidzwa kuri mutsandanyama iyoyo (manometry). Izvi zvinogona kuona kana iri kuvhurika kana kuvhara zvakanaka.
Zvisinei, bvunzo iyi yeERCP ibvunzo diki ine njodzi. Vanhu vashoma vane chirwere ichi vanogona kubatwa nepancreatitis mushure mekuongororwa. Saka, chiremba anokurudzira bvunzo iyi mushure mekunyatsoongorora zvinodiwa uye njodzi.
Inorapwa sei?
Nzira dzekurapa dzinoenderana nerudzi (boka) rweSphincter of Oddi Dysfunction yaunayo.
- Kune Chikamu Chechitatu: Izvi zvakaoma kuona, saka kuvhiyiwa hakukurudzirwi. Chiremba achakupa mishonga inoderedza marwadzo uye mishonga inoderedza marwadzo.
- Kune Chikamu I neChipiri: Kana kurwadziwa kwakanyanya uye kwakaoma kudzora nemishonga, chiremba wako anogona kukupa mushonga unonzi sphincterotomy pamwe chete neERCP .
Chii chinonzi Sphincterotomy iyi?
Izvi zvinosanganisira kucheka chidimbu chidiki chenyama chinonzi Sphincter of Oddi nechinhu chidiki chinopfuudzwa nepachubhu yekamera panguva yekuongororwa kweERCP. Zvadaro, gomba rakamanikana rinovhurwa zvachose. Zvadaro, mvura yekugaya inoyerera ichipinda muura hudiki pasina chipingamupinyi. Izvi zvinopedza marwadzo zvachose.
Asi iyi mishonga ine njodzi. Kunewo njodzi yechirwere chepancreatitis. Saka, kurapwa uku kunoshandiswa kana mimwe mishonga isina kubudirira.
Mharidzo Yekuenda Nayo Kumba
- Kana uchine kurwadziwa mudumbu mushure mekunge gallbladder yako yabviswa, usazviregeredza. Kunogona kunge kuri Sphincter yeOddi Dysfunction.
- Kunyangwe chirwere ichi chisiri chengozi kuhupenyu, kurwadziwa kwacho kunogona kukanganisa hupenyu hwako hwezuva nezuva.
- Zviratidzo hazviwanzoonekwa nguva dzose, chirwere ichi chinowanzo buda nguva nenguva.
- Chiremba wako achasarudza kuti chirwere chako ndechipi (I, II, kana III) kuburikidza nekuongororwa uye achakupa mushonga wakakodzera.
- Vamwe vanhu vanogona kugadzirisa marwadzo avo nemishonga chete. Vamwe vangada kurapwa kwakadai sekuvhiyiwa kwesphincterotomy.
- Usati watanga kurapwa, taura nachiremba wako pachena nezvezvakanakira nezvakaipira.
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